Colon & Colorectal Cancer

Colon cancer forms in the lining of the colon. Rectal cancer forms in the lining of the rectum, the last several inches of the large intestine terminating in the anus. Collectively, these diseases are called colorectal cancer.

In the United States, colorectal cancer is the second deadliest form of cancer of men and women. Each year about 150,000 people will be diagnosed with colon cancer, and 50,000 people will die from the disease, according to the American Cancer Society.

Though scientists are unsure exactly what causes colon and colorectal cancer, some risk factors have been identified.

Colon Cancer Risk Factors

Being 45 or older

Adenomatous polyps, growths inside the colon and rectum that may become cancerous

Many cases of colon or colorectal cancer have no symptoms or warning signs until the cancer has advanced. However, there are some symptoms that may indicate colon cancer, but these symptoms are often confused for other conditions such as hemorrhoids. You should consult with a doctor if you experience any of these symptoms and are unsure of the cause.

Colon Cancer Signs and Symptoms

Abdominal pain or tenderness in the lower abdomen

Bloody stool

Diarrhea, constipation or other changes in bowel functions

Narrower than normal stools

Unexplained anemia

Unexplained weight loss

Bloating, fullness or cramps

Vomiting

Adenomatous Colon Polyps

An adenomatous colon polyp is a growth of extra tissue in the lining of the rectum or colon. It is a benign tumor that can usually be removed during a colonoscopy.

Most colon cancers develop from adenomatous polyps. If a benign adenoma is left to grow in the colon, it can become malignant over time. Therefore, by removing adenomas early, the chances of developing colon cancer are significantly reduced.

People who have a higher risk of adenomatous polyps include those who are 45 and older, who have had polyps previously, or who have a family history of polyps or colon cancer. However, not having a family history of the disease does not eliminate risk. In fact, 80 percent of those diagnosed with colon cancer have no family history.

Polyps generally do not cause symptoms. If a patient does have symptoms, they can include blood in their underwear or on toilet paper after a bowel movement, blood in stool, or constipation or diarrhea that has lasted more than a week.

Colon cancer is highly treatable when discovered early. Depending on an individual's medical and family history, colonoscopies are typically recommended every one, three, five or 10 years.

Colon Cancer Treatments and Procedures

The three primary treatment options for colon cancer are surgery, chemotherapy and radiation. Treatment options for colon cancer depend on the stage of the cancer, whether the cancer has recurred and the patient's overall health.

The surgical option, a partial colectomy, includes removing the affected portion of the colon. How much of the colon is removed and whether the procedure is combined with other treatments depends on the location of the cancer, how deep it has penetrated the wall of the bowel and if it has spread to the lymph nodes or other parts of the body.

In surgical treatment, the part of the colon that contains the cancer, as well as portions of healthy colon on either side, will be removed to ensure no cancer is left behind. Nearby lymph nodes will be removed and tested at the same time. Usually, the doctor is able to reconnect the healthy portions of the colon, but if that is not possible, the patient will have a temporary or permanent colostomy bag.

A colostomy bag is a device connected to the bowel that is attached to the skin discreetly under the clothing. Waste material travels into this bag which is then disposed of, and the bag is replaced as needed. Sometimes, a temporary colostomy is performed to give the bowel time to heal. It may become permanent if too much of the colon or the rectum has to be removed.

If the cancer is small, is in an early stage and is localized in an adenomatous polyp, it is possible it may all be removed during a colonoscopy.

If the cancer is very advanced or the patient's health is extremely poor, surgery may be done simply to provide comfort. This is an operation that will relieve a blockage of the colon to improve symptoms. This will not cure cancer but may relieve pain and bleeding.

Chemotherapy can be used after surgery to destroy any remaining cancer cells and may be recommended by the doctor if the cancer has spread beyond the lining of the colon. Chemotherapy can be used in conjunction with radiation. Radiation therapy uses powerful energy sources to kill any cancer cells that may remain after surgery or to shrink large tumors before an operation. This option is rarely used in the early stages of colon cancer.

Prevent Colon Cancer

Getting screened is the first step in preventing colon cancer. Several screening options are available, including colonoscopy and flexible sigmoidoscopy. As of May 2018, the American Cancer Society revised the recommended age for a first-time colon cancer screening to 45 years old, due to an increased incidence of the disease among people under age 55.

The gold standard for colon cancer screening is colonoscopy because of its ability to examine the entire colon, from cecum to rectum, and both detect and remove adenomatous polyps. Regular colonoscopies should begin at age 45 for people who are at average risk for colon cancer.

If you have a family history of polyps or colon cancer, many physicians may recommend getting your first colonoscopy at age 40 or even earlier depending on your history. Some recent studies indicate that African Americans may need to start screening earlier than age 45. More frequent and earlier screening is recommended if you are at high risk for colon cancer.

To schedule your screening colonoscopy with one of our gastroenterologists, contact us today.

Lifestyle changes can also be made to reduce the risk of colon cancer: